Ballast laxatives

 Psyllium (seeds or seed coats). For centuries, psyllium has been used as a laxative by several peoples. It is a soluble natural fiber (mucilage) taken from the seed of the plantain. Medical authorities recognize its effectiveness in relieving Constipation. Psyllium is available in flakes and powder in health food stores and herbalists. It is the main ingredient in commercial preparations like Metamucil®, Regulan® and Prodiem®. Psyllium has a bland taste.

Dosage

– Soak 10 g of psyllium in 100 ml of lukewarm water for a few minutes. Drink promptly to prevent the mixture from thickening and gelling. Then drink the equivalent of at least 200 ml of water to avoid obstruction of the digestive tract. Repeat 1 to 3 times per day, as needed. Increase the dose gradually until the desired effect is obtained.

– It may be necessary to continue treatment for at least 2 to 3 days before obtaining an optimal laxative effect.

 Linseed. Its mucilage (pectin) explains its laxative effect. Commission E and ESCOP recognize its effectiveness in treating chronic constipation.

Dosage

– Add 1 tsp. tablespoon (10 g) whole seeds, crushed or coarsely ground to a glass of water (150 ml minimum) and drink it all.

– Take 2 to 3 times a day. Some sources recommend soaking them while they release their mucilage, others consider that they must instead swell in the intestines to be effective.

– Flaxseed is most effective if it is first coarsely ground (but not powdered). Rich in polyunsaturated fatty acids, it must be freshly crushed to prevent these unstable fats from going rancid (crushed seeds can only be kept for 1 week in the refrigerator).

– You can take the seeds alone or add them to applesauce, milk, muesli, oatmeal, etc.

 Agar-agar and guar gum. These substances have been used traditionally to treat Constipation. Agar-agar is a substance rich in mucilage extracted from various species of red algae (Gelidium ou Grace). Guar gum is a polysaccharide derived from an Indian plant, guar (Cyamopsis tetragonolobus). They swell on contact with water.

Dosage

— Gomme de guar : take 4 g, 3 times a day (12 g in total) just before or during meals, with at least 250 ml of liquid. Start with a dose of 4 g per day and increase gradually to avoid gastrointestinal discomfort⁶.

— Jelly : Take 5 g to 10 g per day⁷. It is sold in “loaves” or in white powder which is dissolved in water to make a jelly that can be flavored with fruit juice and which can replace gelatin desserts.

 Glucomannane by konjac. Traditionally consumed in Asia, konjac glucomannan has been shown to be effective in relieving Constipation in several uncontrolled studies. In 2008, a small study was conducted on 7 constipated patients to assess the effectiveness of konjac glucomannan supplements (1,5 g, 3 times a day for 3 weeks) compared to placebo in relieving constipation. Glucomannan made it possible to increase stool frequency by 30% and improve the quality of the intestinal flora²⁰. In children, a study published in 2004 (31 children) showed that glucomannan alleviated abdominal pain and symptoms of constipation (45% of children felt better compared to 13% of those treated with placebo). The maximum dose used was 5 g / day (100 mg / kg per day)²¹.

Emollient laxative

 Red elm (red ulmus). The inner part of the bark, the bast, of this tree native to North America is used by Native Americans to treat irritations of the digestive system. Liber is still used today to treat Constipation or provide an emollient and easily digestible food to convalescents.

Dosage

See the slippery elm porridge recipe in the Elm sheet in the Medicinal Herbarium section.

Stimulating laxatives

This type of laxative is usually made from plants that contain anthranoids (or anthracenes). Dosage is based on the anthranoid content, not the weight of the dried plant⁷. The dosage can be adjusted to use the smallest amount needed to achieve soft stools. Do not exceed 20 mg to 30 mg of anthranoids per day.

 Castor oil (Ricinus communis). Castor oil is in a class of its own in the world of stimulant laxatives because it does not contain anthranoids. It owes its purgative activity to a fatty acid, ricinoleic acid, which forms sodium salts. Medical authorities recognize its effectiveness in treating constipation on an ad hoc basis.

Dosage

It is taken at a rate of about 1 to 2 tbsp. tsp (5 g to 10 g), in adults⁷. It takes about 8 hours to work. For a faster effect, take a maximum of 6 tbsp. (30 g). Taken on an empty stomach, it is more effective.

Cons-indications

People with gallstones or other gallbladder problems.

 Senna (Cassia angustifolia ou Cassia Senna). The effectiveness of senna in treating constipation, in the short term, is recognized by medical authorities. Several laxative products obtained over the counter contain senna extracts (Ex-Lax®, Senokot®, Riva-Senna®, etc.). The husk of senna seeds contains 2% to 5,5% anthranoids, while the leaves contain about 3%.⁷.

Dosage

— Follow the manufacturer’s recommendations.

– You can also infuse 0,5 g to 2 g of senna leaves in lukewarm water for 10 minutes. Take a cup in the morning and, if needed, a cup at bedtime.

– Clove: infuse, for 10 minutes, ½ tsp. level teaspoon of powdered pods in 150 ml of lukewarm water. Take a cup in the morning and, if necessary, a cup in the evening.

 Sacred shell (Rhamnus purshiana). The bark of this tree native to the Pacific coast of North America contains about 8% anthranoids. Commission E approves its use to deal with Constipation. Several laxative products contain it, especially in the United States.

Dosage

Take 2 ml to 5 ml of liquid standardized extract, 3 times a day.

It can also be taken as an infusion: infuse 5 g of dried bark in 10 ml of boiling water for 2 to 150 minutes and filter. Take one cup a day. Its smell, however, is unpleasant.

 Aloe latex (Aloe vera). Widely used in Europe, aloe latex (yellow sap present in the tiny canals of the bark) is much less used in North America. Powerful purgative, it contains 20% to 40% anthranoids. Commission E, ESCOP and the World Health Organization recognize its effectiveness in treating occasional constipation.

Dosage

Take 50 mg to 200 mg of aloe latex in the evening, at bedtime. Start with small doses and increase as needed, as the laxative effect can occur at widely varying doses, depending on the person.

 Buckthorn (Rhamnus frangulates or buckthorn). The dried bark of the trunk and branches of buckthorn, a shrub found in Europe and Asia, contains 6% to 9% anthranoids. Its berries also contain it, but a little less (from 3% to 4%). Its effect is a little lighter than that of other plants. Commission E recognizes its effectiveness in treating constipation.

Dosage

— Infuse 5 g of dried bark in 10 ml of boiling water for 2 to 150 minutes and filter. Take one cup a day.

– Infuse 2 g to 4 g of buckthorn berries in 150 ml of boiling water for 10 to 15 minutes, then filter. Have a cup in the evening and, as needed, in the morning and afternoon.

 Rhubarb root (Rheum sp.). Rhubarb roots contain about 2,5% anthranoids⁷. Its laxative effect is mild, but some people are more sensitive to it than others.

Dosage

Consume 1 g to 4 g of dried rhizome per day. Grind finely and take with a little water. There are also alcohol-based tablets and extracts.

 Boldo. Commission E and ESCOP have approved the use of boldo leaves to treat various gastrointestinal disorders, including Constipation.

Dosage

Commission E recommends 3 g of dried leaves per day for digestive disorders¹². Please note that boldo should not be used in the elderly, as it could be toxic for the liver²².

Other

 probiotics

There are a few clinical trials showing the likely beneficial effect of probiotics on constipation.^23-25 . The frequency of bowel movements increases by 20% to 25% with a daily intake of probiotics. In adults, probiotics that increase the frequency of bowel movements and improve their consistency are the Bifidobacterium animalis (DN-173 010), the Lactobacillus casei Shirota, and theEscherichia coli Nissle 1917. In children, L. casei rhamnosus Lcr35 has shown beneficial effects²⁵.

 Dandelion. A few rare preliminary clinical trials indicate that dandelion preparations may relieve Constipation. Fresh or dried dandelion leaves, like the root, are traditionally used as an infusion for their mild laxative properties.¹².

therapies

 biofeedback. Perineal rehabilitation using biofeedback (also called biofeedback) is effective in treating difficulty in defecating in adults (terminal constipation). Rehabilitation by biofeedback must be carried out in a specialized center, and consists of exercises of voluntary relaxation of the muscles of the pelvic floor (using a balloon catheter). Biofeedback allows you to “relearn” to synchronize the relaxation of the anal sphincter and pushing efforts. Usually 3 to 10 sessions are needed to get results²⁶.

 Colon irrigation. Some people with Constipation chronic¹⁰ have obtained good results with colon irrigation. Consult a hygienist or naturopath. See also our Colon Hydrotherapy sheet.

 Massage therapy. An abdominal massage therapist can help stimulate bowel contractions and mobilize fluids¹¹. It is also possible to massage your stomach yourself by making clockwise rotational movements around the navel. This helps restart bowel movements, especially in constipated children or babies. See our Massotherapy file.

 Traditional Chinese Medicine. Acupuncture may be helpful in cases where bowel movements are so irregular that laxatives are ineffective.¹¹. Traditional Chinese herbal medicine might also help. Consult a practitioner.

 Psychotherapy. If you have a chronic constipation, the psychological aspects are not to be neglected¹². As with sleep, elimination functions can be inhibited when overthinking. See our Psychotherapy sheet and the associated sheets under the Complementary approaches tab to find out about the different types of psychotherapy.

 Reflexology. Reflexology treatments could help relax body and mind. They would activate intestinal transit by stimulating reflex zones and breaking down energy blockages¹⁰.